OncologyWIKISpring2012 - Peripheral Neuropathy

Pain
- Patients may report shooting or stabbing pain but pain may also come and go.
- Patients may report numbness or they may report a lessened ability to sense pressure, touch, or heat.
Burning feeling in extremities like hands and feet
Tingling feeling
Loss of feeling in extremities
Trouble using your fingers to pick up or hold things
Balance problems
Pressure or temperature may hurt more than usual
Muscle weakness
Trouble swallowing
Constipation
Trouble passing urine
Blood pressure changes
Decreased or no reflexes

Neuro exam
CT Scan
MRI
Nerve Biopsy
- Very rarely performed, can cause nerve damage
NCV
- Nerve conduction velocity test, measure speed of nerve impulse
- Measure degree of damage in nerve fibers
- Determines cause of nerve damage: demylinazation (slow transmission of nerve impulse) or axon damage (decreased impulse strength)
EMG (Electromyography)
- Inserting needle into muscle to measure electric activity while muscle is active and when it is at rest.
- Helps differentiate between muscle and nerve disorders

Platinum drugs like cisplatin, carboplatin, and oxaliplatin
Taxanes including paclitaxel (Taxol) and docetaxel (Taxotere)
Epothilones such as ixabepilone (Ixempra)
Plant alkaloids such as vinblastine, vincristine, vinorelbine, and etoposide (VP-16)
Thalidomide (Thalomid) and lenalidomide (Revlimid)
Bortezomib (Velcade)

Teach patients the importance of medication compliance.
Teach patient to avoid extreme temperatures.
Teach patient to avoid shoes that are too tight.
Teach patient to avoid alcohol, it may make CIPN worse.
Teach diabetic patients the importance of controlling their diabetes & importance of controlling their blood sugar.
Teach patients to use knives, scissors, box cutters, and other sharp objects gently and carefully.
Teach patients to protect their hands by wearing gloves when they are cleaning, work outdoors, or do repairs.
Teach patients to how to care for their feet.
- Instruct them to look at their feet once a day to see if you have any injuries or open sores. Instruct them to always wear shoes that cover your whole foot when walking, even at home.
Teach patients to be sure that they have ways to support themselves if they have problems with balance.
Teach patient how to use a walker or cane for extra support.
Teach patient to advocate for themselves!
- Teach patient to report signs & symptoms and concerns to health care provided.